The Role of Insulin Resistance/Hyperinsulinism on the Rising Trend of Thyroid and Adrenal Nodular Disease in the Current Environment

Journal of Clinical Medicine
Agathocles Tsatsoulis

Abstract

Thyroid follicular cells, as well as adrenocortical cells, are endowed by an intrinsic heterogeneity regarding their growth potential, in response to various stimuli. This heterogeneity appears to constitute the underlying cause for the focal cell hyperplasia and eventually the formation of thyroid and adrenal nodules, under the influence of growth stimulatory factors. Among the main stimulatory factors are the pituitary tropic hormones, thyroid-stimulating hormone (TSH) or thyrotropin and adrenocorticotropic hormone (ACTH), which regulate the growth and function of their respective target cells, and the insulin/insulin-like growth factor system, that, through its mitogenic effects, can stimulate the proliferation of these cells. The predominance of one or the other of these growth stimulatory factors appears to determine the natural history of thyroid and adrenal nodular disease. Thus, iodine deficiency was, in the past, the main pathogenic factor responsible, through a transient rise in TSH secretion, for the endemic nodular goiter with the characteristic colloid thyroid nodules among the inhabitants in iodine deficient areas. The correction of iodine deficiency was followed by the elimination of endemic colloid goiter and th...Continue Reading

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Citations

Jan 19, 2019·The Journal of Clinical Endocrinology and Metabolism·Yevgeniya S KushchayevaRebecca J Brown
Apr 16, 2019·European Journal of Endocrinology·Chin-Hsiao Tseng
Mar 24, 2021·Internal and Emergency Medicine·Sibel Demiral Sezer, Elçin Erdoğan Yücel
Apr 28, 2021·Proceedings of the National Academy of Sciences of the United States of America·Ritwik DattaKamran Atabai

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